United States Patent [19]
[11] Patent Number:
Fischer, Jr.
[45]
[54] METHOD AND APPARATUS FOR
REPLACING A PLACED ENDOTRACHEAL
TUBE
'
[751 Inventor:
Frank J. Fischer, Jr., Bloomington,
Ind.
[73] Assignee: Cook, Inc., Bloomington, Incl.
l2 1] Appl. No.: 420,550
Oct. 12, 1989
[22] Filed:
[51] Int. Cl.5 ........................................... .. A61M 16/04
[521 US. Cl. ........................ .. 128/207.l5; 128/22026;
128/912; 285/322
[58]
Field of Search .................... .. 128/207.15, 207.14,
128/200.26, 911, 9112, DIG. 26, 207.16;
285/322, 323
References Cited
[56]
6/1962
4/1972
Fountain ...................... .. 128/20026
Sapy et a1.
......... .. 285/322
3,948,273
4/1976
Sanders
l28/207.15
4,231,365 11/1980
Scarberry ..
4,275,907
4,327,720
6/1981
5/1982
Hunt ....................... .. 285/323
Bronson et a1. ..
.... .. 128/207.15
4,328,983
5/1982
Gibson
. . . .. . . . . . . . . .
4,329,987
5/1982
Rogers et al. .
4,334,534
6/1982
Ozaki
4,398,757
8/1983
Floyd et a1.
4,716,896
l/1988
Ackerman
. ... ..... ....
.... .. 128/207.15
. . . . . ..
285/382
..... .. 285/322
. . . . ..
128/207.l5
......... .. 285/322
.....
. . . . ..
128/20026
4,819,664 4/1989
4,846,167 7/1989
4,865,586 9/1989
4,892,095 1/1990
4,960,122 10/1990
.
Mizus ........................... .. l28/207.l4
FOREIGN PATENT DOCUMENTS
445218
4/1936
OTHER PUBLICATIONS
~“Mettro Mizus Endotracheal Tube Replacement Obtu
rator Cook ® Critical Care”, Cook Incorporated, 1988.
Primary Examiner-Edgar S. Burr
‘Assistant ExamineF-Stephen R. Funk
Attorney, Agent, or Firm-Richard J. Godlewski
[57]
ABSTRACT
Method and apparatus are disclosed for replacing an
endotracheal tube. The apparatus comprises ‘an endotra
cheal tube obturator having an air passageway therein
and a removable connector positioned at the proximal
end of the obturator tube for ventilating the patient
during replacement of the endotracheal tube. The obtu
rator tube also includes a plurality of side ports for
further ventilating the patient should mucous block the
removable and lockable obturator tube ?tting joined
3,039,469
3,653,689
. . . . ..
Oct. 1, 1991
distal end of the obturator tube passageway. The re
movable connector includes a ventilator ?tting and a
U.S. PATENT DOCUMENTS
.....
Date of Patent:
5,052,386
United Kingdom ......... .. l28/200.26
thereto. The obturator tube ?tting includes a sleeve
having a plurality of ?exible members for grasping the
proximal end of the obturator tube. Extending into the
passageway of the sleeve is a projection from the mem
bers for engaging the outside surface of the obturator
tube when inserted in the passageway. A collar is slide
ably positionable about the sleeve between two retain
ing ?anges for engaging a cam surface positioned on the
‘ ?exible members for forcing the projections into the
outside surface of the obturator tube. The apparatus is
inserted into a placed endotracheal tube for ventilating
the patient while the endotracheal tube is replaced. The
quick removal connector permits the timely replace
ment of the endotracheal tube while maintaining venti
lation of the patient.
23 Claims, 3 Drawing Sheets
US. Patent
Oct. 1, 1991
Sheet 1 of 3
5,052,386
U.S. Patént
'
Oct. 1, 1991
Sheet 2 of 3
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SUMMARY OF THE INVENTION
The foregoing problems are solved and a technical
advance is achieved with illustrative method and appa
ratus for replacing an endotracheal tube placed in a
METHOD AND APPARATUS FOR REPLACING A
PLACED ENDOTRACHEAL TUBE
TECHNICAL FIELD
This invention relates to medical devices and particu
larly to method and apparatus for replacing a placed
endotracheal tube.
' patient. The apparatus includes an obturator tube hav
ing an airway therein, which is insertable into the pas
sageway of the endotracheal tube for ventilating the
patient during replacement. Furthermore, the apparatus
includes a removable connector positioned about the
proximal end of the obturator tube for connection to a
BACKGROUND OF THE INVENTION
Presently, the replacement of an endotracheal tube
placed in a patient includes disconnecting the endotra
ventilator. This removable connector also has a lock
mechanism for ensuring continued connection with the
obturator tube. As a result, this replacement apparatus
advantageously provides a positive means of ventilating
cheal tube from a ventilator and inserting a sealed endo
tracheal obturator into the airway of the tube. The
obturator is passed completely through the endotra
the patient during replacement of the placed endotra
cheal tube and into the trachea of the patient. The endo
tracheal tube is then removed from the trachea of the
patient over the obturator while the obturator remains
in the trachea of the patient. Since the tissue surround
ing a chronically placed endotracheal tube often be
comes inflamed, an obturator is positioned in the pas
sageway of the endotracheal tube to provide a guide for
cheal tube.
Illustratively, the method for replacing a placed en
dotracheal tube while maintaining ventilation of the
patient includes disconnecting the placed endotracheal
tube from the ventilator apparatus and connecting the
obturator tube to the ventilator apparatus. The connec
tion of the obturator tube includes the use of the remov
able connector which includes a standard ventilator
inserting the replacement tube through the in?amed
tissue of the patient’s airway. Furthermore, the patient’s
?tting. The method further includes inserting the obtu
airway tissue may have become so in?amed as to com
rator tube into the placed endotracheal tube and remov
pletely encapsulate the obturator and essentially cut off
air flow to the lungs. In many cases, the replacement
endotracheal tube is simply inserted over the positioned
obturator and quickly inserted into the patient’s airway.
ing the placed endotracheal tube from the patient over
the obturator tube. The obturator tube is disconnected
As a result, ventilation of the patient is restored without
any adverse affect to the patient. The obturator is with ;
drawn from the replacement endotracheal tube, and the
replacement endotracheal tube is connected to the ven
tilation apparatus to resume normal ventilation of the 35
patient.
However, during this replacement procedure, it is not
from the ventilator apparatus and the endotracheal
removed from about the obturator tube. The disconnec
tion step is facilitated by the use of the removable con
nector which is unlocked and removed from the proxi
mal end of the obturator tube to permit removal of the
removed endotracheal-tube over the obturator tube.
The replacement endotracheal tube is then inserted
over the obturator tube with the obturator tube being
reconnected to the ventilator apparatus utilizing the
removable and lockable connector. The obturator tube
and removable connector advantageously minimize the
uncommon to encounter problems in the insertion of the
replacement endotracheal tube. The tissue of the pa
tient’s airway passage may have become so in?amed so 40 time period in which the ventilator apparatus is not
as to make'the insertion of the replacement endotra
providing positive ventilation of the patient. With the
cheal tube a time-consuming process even with the
obturator tube providing ventilation of the patient dur
obturator positioned in the patient. The insertion of the
ing removal of the endotracheal tube and the insertion '
of the replacement, the physician has ample time for
replacement endotracheal tube may also cause trauma
or bleeding to the airway passage tissue further compli
cating the replacement process. The physician can
readily accommodate these complications; however,
time becomes a critical factor when the in?amed tissue
has entirely blocked the airway preventing normal ven
tilation of the patient.
Instead of a sealed obturator, physicians have been
45
placing the replacement tube with minimal, if any,
trauma to the already in?amed tissue of the patient’s
airway. After the replacement endotracheal tube is
placed, the obturator tube is removed and disconnected
from the ventilator apparatus. The ventilator apparatus
50 is then reconnected to the patient.
The obturator tube of the replacement apparatus also
known to cut off a length of medical grade tubing with ‘
includes one or more indicators positioned a predeter
an airway therein to serve as an endotracheal tube obtu
mined distance from the distal end of the tube for indi
cating the position of the obturator tube in the placed
the severely in?amed tissue condition, this tube pro 55 endotracheal tube. In the illustrative embodiment, these
indicators include a radiopaque substance which is
vides limited ventilation of the patient during the re
painted on the outside of the obturator tube. This ad
placement procedure. However, the cut~off tube does
vantageously provides the physician with a visual indi
not have any ?tting or connector for connection to
cation of the depth of penetration of the obturator tube
ventilating equipment during the replacement proce
dure. Furthermore, the distal end of this makeshift ‘obtu 60 in the patient. Furthermore, the radiopaque indicator
provides X-ray or ‘other aided visualization of the obtu
rator often becomes blocked with mucous as the tube
rator tube in the patient.
extends beyond the distal end of the endotracheal tube.
Should the distal end of the obturator tube become
Such blockage is commonly unknown to the physician
blocked with patient mucous, the obturator tube advan
until the endotracheal tube is removed. As a result, the
rator. In those instances where the physician is aware of
makeshift obturator does not alleviate the ventilation 65 tageously includes a plurality of side ports positioned '
about the distal end of the tube for further ventilating
the patient during replacement of the endotracheal
and, in fact, prolongs the procedure due to it being more
tube.
?exible than most endotracheal obturators.
problem during a prolonged replacement procedure
5,052,386
3
.
4
cuff and for providing a visual indication of the in?ation
of the cuff.
The method for replacing endotracheal tube 101
A signi?cant departure in the art includes the use of
the removable and lockable connector of the replace
ment apparatus for connecting the obturator tube to
ventilator apparatus. lllustratively, the connector in
cludes a ventilator tube ?tting and an obturator tube
placed in patient 103 while maintaining ventilation
thereof, comprises disconnecting the endotracheal tube
?tting ultrasonically joined together. The obturator
‘ from ventilator apparatus (not shown) at endotracheal
tube ventilator connector 107 and connecting the venti
tube ?tting includes a sleeve having a passageway for
lator apparatus to endotracheal tube replacement appa
receiving the proximal end of the obturator tube. The
ratus 100 via removable ventilator connector 109. The
sleeve is slotted from the distal end to form a plurality of
radially ?exible members for grasping the proximal end
of the obturator tube. A ridge or projection extending
radially and inwardly into the sleeve passageway grasps
the preferably semi-rigid material of the obturator tube.
This ?xedly positions the tube longitudinally in the
obturator tube is inserted through ventilator connector
provide easy disengagement of the locking collar, the
sulates the obturator tube, thereby preventing the pas
107 and passageway 108 of the endotracheal tube be
yond the distal end thereof and into the trachea 102 of
the patient. When inserted as shown and connected to
the ventilator apparatus, positive ventilation of the pa
tient is maintained. The endotracheal tube is then re
connector. The obturator tube ?tting also includes a
moved from the trachea and airway of the patient over_
ring-like collar positioned about the sleeve and engage
the obturator tube while the obturator tube remains
able with the radially ?exible members for moving the
placed in the trachea of the patient. With a chronically
?exible members and the projection t‘ ereon into the
placed endotracheal tube, it is common for the tissue of
surface of the obturator tube. The ?exible members
20 the patient’s airway to become in?amed thereby encap
include a cam surface at the distal end thereof for en
sulating the endotracheal tube. When the endotracheal
gaging the ring-like collar. To unlock the ?tting to
tube is removed, the in?amed tissue commonly encap
surface adjacent the cam surface is recessed below the
sage of air through the patient’s airway around the
cam surface to limit the amount of engagement of the 25 obturator tube. Since the obturator tube includes a pas
collar with the cam surface.
' sageway therein, ventilation of the patient is maintained
To provide an airtight seal, the connector of the re
even though the in?amed tissue encapsulates the obtu- '
placement apparatus includes an O-ring seal positioned
at the proximal end of the obturator tube ?tting for
pneumatically sealing the obturator tube in the sleeve
rator tube.
When the endotracheal tube is removed from the
passageway of the patient over the obturator tube, re
movable connector 109 is removed from obturator tube
passageway.
BRIEF DESCRIPTION OF THE DRAWINGS
106, thereby disconnecting the obturator tube from the
drawing of the replacement apparatus of the invention
depicted in FIG. 1;
the obturator tube, thereby reconnecting the ventilator
ventilator apparatus. The removed endotracheal tube is
FIG. depicts illustrative endotracheal tube replace
then completely removed from the patient over the
ment apparatus of the present invention for removing an 35 obturator tube and a replacement endotracheal tube is
endotracheal tube placed in a patient;
inserted over the obturator tube. The removable con
FIG. 2 depicts a partially sectioned and more detailed
nector is reconnected and locked to the proximal end of
FIG. 3 depicts the obturator tube of FIGS. 1 and 2
fully inserted in the removable connector of the present
apparatus to the obturator tube for providing continued
ventilation of the patient. When the ventilator apparatus
is reconnected to the obturator tube, the physician is
invention with a locking collar partially engaged; and
FIG. 4 depicts the obturator tube fully inserted in the
removable connector in a fully locked position.
permitted ample time to place the replacement endotra
cheal tube in the trachea of the patient without causing
trauma to the surrounding in?amed tissue of the airway.
45
After the physician places the replacement endotra
DETAILED DESCRIPTION
Depicted in FIG. 1 is illustrative endotracheal tube
replacement apparatus 100 for replacing an endotra
cheal tube 101 placed in trachea 102 of patient 103. The
endotracheal tube is a well-known medical device and is 50
cheal tube in the airway and trachea of the patient, the
obturator tube is removed from the ventilating passage
way of the endotracheal tube and disconnected from
the ventilator apparatus. The ventilator apparatus is
then connected to the endotracheal tube placed in the
placed through mouth 104 and airway 105 and into the
trachea of the patient. The endotracheal tube replace
patient.
Depicted in FIG. 2 is a more detailed and partially
sectioned view of endotracheal tube replacement appa
inserted through ventilator connector 107 and ventilat
ratus 100. As shown, replacement apparatus 100 basi
ing passageway 108 of the endotracheal tube and into 55 cally comprises obturator tube 106 and removable and
the trachea of the patient. The replacement apparatus
lockable connector 109. Obturator tube 106 is prefera
bly of a semi-rigid material such as radiopaque polyeth
also includes a removable connector 109 positioned
ylene and includes proximal end 110 and distal end 116
about proximal end 110 of the obturator tube for venti
lating the patient during replacement of the endotra
with air passageway 117 therebetween. The outside
cheal tube. Endotracheal tube 101 is a well-known med 60 diameter of this semi-rigid obturator tube is typically 18
ment apparatus includes an obturator tube 106 which is
ical device and typically includes an in?atable cuff 111
positioned at the distal end thereof for securely posi-'
tioning and sealing the distal end of the endotracheal
French for inserting through standard ventilator con- '
nectors such as 107 and into passageway 108 of endotra
cheal tube 113. The inside diameter _of the obturator
tube is 0.115”. A plurality of side ports such as port 118
tube in the trachea. This cuff is in?atable with air sup
plied through an in?ation tube 112 attached to the exter 65 is positioned approximately 1” from distal end 116 for
providing further ventilation of the patient. Side ports
nal surface of endotracheal tube 113. An in?atable bal
are elliptical or oval in shape for providing the largest
loon 114 and an airtight connector 115 are positioned at
area port without signi?cantly weakening the structure
the proximal end of the in?ation tube for in?ating the
5
5,052,386
6
shown, the proximal end 110 of the obturator tube
of the tube. The side ports provide ventilation of the
?exes the distal end of the members in an outward di
patient should mucous enter passageway 117 at the
distal end. The obturator tube is typically 70 cm in
length with a plurality of indicators such as 119 and 120
rection due to the projections engaging the outside
surface of the obturator tube.
Cylindrically shaped ?exible members 130 and 131
positioned approximately 13 and 40 cm from the distal
end thereof. The length of the tube is somewhat more
than twice the length of the endotracheal tube to permit
' have a conically shaped cam surface 135 and 136 at their
distal ends. The inside surface 137 of ring-like collar 126
engages these cam surfaces when the collar is moved
These indicators are formed on the outer surface of the ' toward the distal end of the members as shown. When
the inside surface of the collar engages the cam surfaces,
tube with, for example, commercially-available Mar
projections 132 and 133 are forced in an inward direc
kem ink which is a radiopaque ink distinguishable from
tion indicated by the arrows and into the outside surface
the radiopaque obturator tube material. The physician
of semi-rigid material obturator tube 106.
visually observes these indicators during the insertion of
As depicted in FIG. 4, collar 126 has been moved to
the tube into the endotracheal tube for indicating rela
tive positioning of the obturator tube in the patient. 15 a fully distal position to engage retainer ?ange 128 at
the distal end of the members. The inside of the collar is
Further veri?cation of the positioning of the obturator
cut to form‘a notch 138 to engage retaining ?ange 128.
tube in the patient is provided with the radiopaque
When moved to a fully distal position, surface 137 of the
property of the tube and indicators visualized with the
collar fully engages the cam surfaces forcing projec
use of, for example, X-ray equipment. The distal end
116 of the tube is rounded for minimizing trauma to the 20 tions 132 and 133 fully into the outside surface of obtu
rator tube 106. As a result, the ?exible members and
trachea of the patient. In a similar manner, proximal end
projections ?xedly position longitudinally the proximal
110 is rounded to provide an airtight or pneumatic seal
end of the obturator tube in the ?tting passageway.
with connector 109 when inserted therein.
When collar 126 has been extended to a full distal
As depicted in FIG. 2, removable connector 109
includes a well-known ventilator ?tting 121 and obtura 25 position engaging retaining ?ange 128, the removable
connector is in a “locked position.” To unlock the re
tor tube ?tting 122 that are joined together. As illus
movable connector, collar 126 is slid by the physician to
trated, ventilator ?tting 121 is preferably of a plastic
the proximal position disengaging cam surface 135 and
material such as polycarbonate which is available from
136 of ?exible members 130 and 131, respectively. The
Bivona, Inc. of Gary, Ind. The ventilator ?tting is avail
able as part No. CO-30 from Bivona with a male nipple 30 ?exible members include a recessed surface or notch
139 and 140 of respective ?exible members 130 and 131.
(not shown) for insertion into a ventilator tube. The
These recessed surfaces adjacent cam surfaces 135 and
ventilator ?tting is modi?ed by removing the nipple and
136 limit the engagement of the collar with the ?exible
increasing distal opening 123 to approximately 0.250".
handling thereof during the replacement procedure.
members. As a result, the force necessary to move the
The removable and lockable’ obturator tube ?tting
122 of the present invention is also preferably of a plas 35 collar to a proximal position is signi?cantly reduced.
However, suf?cient force is exerted by the semi-rigid
tic material such as polycarbonate which is ultrasoni
tube against the projections and ?exible members to
cally welded to the distal end of ventilator ?tting 121.
maintain the connector in a “locked” position.
The obturator tube ?tting 122 comprises a slotted sleeve
Although the removable connector has been de
124v having a passageway 125 and a ring-like collar 126
positioned thereabout between radially extending
40 scribed for interconnecting an obturator tube to ventila
?anges 127 and 128 at the respective ends of the sleeve.
tor apparatus, this removable connector may be used
Sleeve 124 has a plurality of slots such as 129 formed
for any number of applications for interconnecting two
tubes for which quick-release is desired.
from the distal end. The slotting of the sleeve produces
Of course, it will be understood that the aforemen
a plurality of ?exible members 130 and 131, Which are
radially ?exible at the distal end. When proximal end 45 tioned endotracheal tube replacement apparatus and
method is merely illustrative of the application of the
110 of the obturator tube is inserted in passageway 125,
principles of this invention'and that numerous other
the ?exible members move in a radially outward direc
arrangements may be devised by those skilled in the art
tion. Each ?exible member includes a projection or
without departing from the spirit and scope of the in
ridge such as 132 and 133 extending into passageway
125. The dimension between the peaks of opposing 50 vention. In particular, the projections extending from
the ?exible members may be positioned elsewhere along
projections of the ?exible members is less than the out
the length of the sleeve passageway. This provides
side diameter of the obturator tube. As a result, when
additional force if required depending on the durometer
- the obturator tube is inserted in passageway 125, the
of the semi-rigid material. The depth or the height of
distal end of the ?exible members are moved in an out
ward direction due to the surface of the obturator tube 55 the projections may also be increased to further extend
into a softer material tube. In addition, any number of
engaging the projections.
different connector ?ttings may be ultrasonically
Depicted in FIG. 3 is a partially sectioned view of the
welded or joined to the lockable and removable ?tting
replacement apparatus of FIG. 2 with the proximal end
of the present invention.
110 of the obturator tube fully inserted into passageway
125 of obturator tube ?tting 122. As shown, the proxi 60 What is claimed is:
1. Apparatus‘ for replacing an endotracheal tube
mal end of the obturator tube engages O-ring seal 134
placed in a patient, comprising:
positioned at the proximal end of the obturator tube
tubular obturator means for ventilating said patient
?tting. The O-ring seal is positioned in recess 141 at the
proximal end of the obturator tube ?tting. This O-ring
seal is made preferably of commercially available Burla 65
N rubber. When the proximal end of the tube is posi
during replacement of said endotracheal tube, said
obturator means being insertable into a passageway
tioned next to the O-ring seal, obturator tube 106 is
of said endotracheal tube and having distal and
proximal ends, a passageway extending there
pneumatically sealed in ?tting passageway 125. As also
through, an outside surface extending longitudi
5,052,386
7
nally therealong, and said outside surface of said
' obturator means being passable throughout the
entire length of said passageway of said endotra
cheal tube so that the entirety of said obturator
means may pass through said passageway of said
endotracheal tube; and
removable connector means positioned about said
proximal end and ?xedly engaged with said outside
8
14. The obturator of claim 13 wherein said removable
ventilator connector includes an O-ring seal.
15. The obturator of claim 13 wherein said tube ?t
ting comprises a sleeve having a passageway for said
proximal end of said semi-rigid tube.
16. The obturator of claim 15 wherein said sleeve
further comprises a plurality of radially ?exible mem
bers, said members grasping said outside surface of said
proximal end of said semi-rigid tube when positioned in
ing said outside surface and connecting said tubular 10 said sleeve passageway.
17. The obturator of claim 16 wherein said radially
obturator means to a ventilator.‘
?exible members include a projection extending into
2. The apparatus of claim 1 wherein said tubular
surface of said tubular obturator means for engag
said sleeve passageway and forced into said outside
obturator means includes indicator means positioned a
surface of said semi-rigid tube.
predetermined distance from said distal end for indicat
18. The obturator of claim 17 wherein said radially
ing the position of said tubular obturator means in said 15
?exible members include a conically-shaped cam sur
endotracheal tube.
face and wherein said tube ?tting further comprises a
3. The apparatus of claim 1 wherein said tubular
collar longitudinally positionable about said sleeve and
obturator means includes side port means positioned
engageable with said comically-shaped ca'..1 :urface,
about said distal end for further ventilating said patient
when engaged with said ?exible members said collar
during replacement of said endotracheal tube.
4. The apparatus of claim 1 wherein said removable 20 forcing said projection into said outside surface of said
semi-rigid tube when inserted in said sleeve passage
connector means includes sleeve means having a pas
way.
sageway for receiving said proximal end of said tubular
19. The obturator of claim 18 wherein said radially
obturator means.
?exible members include a recessed surface adjacent
5. The apparatus of claim 4 wherein said sleeve means
includes radially ?exible means for grasping said outside 25 said conically-shaped cam surface, said recessed surface
limiting engagement of said collar with said radially
surface about said proximal end of said tubular obtura
?exible members.
tor means.
20. The obturator of claim 17 wherein said tube ?t
6. The apparatus of claim 5 wherein said radially
ting comprises a colar positioned around and engage
?exible means includes said projection means extending
into said sleeve passageway for ?xedly and longitudi 30 able with said radially ?exible members, when engaged
with said members said collar forcing said projection
nally positioning said proximal end of said tubular obtu
into said outside surface of said semi-rigid tube when
rator means in said sleeve passageway.
inserted in said sleeve passageway.
7. The apparatus of claim 5 wherein said removable
21. Method for replacing an endotracheal tube placed
connector means includes collar means engageable with
said radially ?exible means for ?xedly and radially posi 35 in a patient while maintaining ventilation thereof, com
prising:
tioning said radially ?exible means' when said tubular
disconnecting said endotracheal tube from ventilator
obturator means is in said sleeve passageway.
apparatus;
8. The apparatus of claim 7 wherein said radially
?exible means includes means for limiting engagement
of said collar means with said radially ?exible means.
9. The apparatus of claim 4 wherein said removable
connector means includes seal means for pneumatically
sealing said tubular obturator means in said sleeve pas
sageway.
10. The apparatus of claim 1 wherein said removable 45
connector means includes lock means for ?xedly posi
tioning said removable connector means about said
proximal end of said tubular obturator means.
11. An endotracheal tube obturator comprising:
a semi-rigid tube insertable into a passageway of an
endotracheal tube, said semi-rigid tube having dis
tal and proximal ends, a passageway extending
therethrough, an outside surface extending longitu
dinally therealong, said outside surface of said
semi-rigid tube being passable throughout the en
tire length of said passageway of said endotracheal
tube so that the entirety of said semi-rigid tube may
pass through said passageway of said endotracheal
tube, and a plurality of side ports positioned about
said distal end; and
_
a removable ventilator connector positioned about
connecting an endotracheal obturator tube having a
passageway therein to said ventilator apparatus;
inserting said obturator tube in said endotracheal
tube;
'
removing said endotracheal tube from said patient over said obturator tube;
disconnecting said obturator tube from said ventilator
apparatus;
removing said endotracheal tube from about said
obturator tube;
inserting a replacement endotracheal tube over said
obturator tube;
‘ '
reconnecting said obturator tube to said ventilator
apparatus;
placing said replacement endotracheal tube in said
patient;
removing said obturator tube;
disconnecting said obturator tube from said ventilator
' apparatus; and
connecting said ventilator apparatus to said replace
ment endotracheal tube placed in said patient.
22. The method of claim 21 wherein the step of dis
connecting said obturator tube from said ventilator
apparatus includes disconnecting a removable connec
said proximal end and ?xedly engageable with said
tor interconnecting said ventilator apparatus and said
outside surface of said semi-rigid tube.~
obturator tube, from said obturator tube.
_
12. The obturator of claim 11 wherein said semi-rigid
23. The method of claim 22 wherein the step of re
tube has a radiopaque indicator positioned a predeter
65 connecting said obturator tube to said ventilator appara- '
mined distance from said distal end.
‘tus includes reconnecting said removable connector to
13. The obturator of claim 11 wherein said removable
ventilator connector includes a ventilator ?tting and a
tube ?tting joined together.
said obturator tube. ‘
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